Organization · Type 2 NPI

State of Tennessee

Clinical Medical Laboratory · Jackson, TN

NPI number 1396983276 Active

Practice location

295 Summar Dr
Jackson, TN 38301-3905

Fax (731) 421-5199

Specialties and licenses

Taxonomy	Code	License
Clinical Medical Laboratory Primary	291U00000X	0000002293 (TN)

Clinical Medical Laboratory: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to det…

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NPI record

NPI: 1396983276
Entity type: Organization (Type 2)
Issued: Jan 30, 2009
Last updated: Jun 16, 2009
Status: Active
Subpart: Yes of Tennessee Department of Health

Other names

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Jackson Regional Laboratory · doing business as

Authorized official

Dr. Oristyne E. Walker, PhD
Laboratory Director
(731) 426-0686

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1396983276

State of Tennessee's National Provider Identifier is 1396983276, issued on Jan 30, 2009. The primary taxonomy on file is Clinical Medical Laboratory (291U00000X), and the practice location is in Jackson, TN. The record was last updated on Jun 16, 2009.